Kenya's First Ever OST Program Begins in Nairobi
Tanzania's first methadone clinic in Dar es Salaam
Kenya recently opened the country's first ever opioid substitution treatment (OST) program, becoming the sixth Sub-Saharan African country where OST is available.
Starting in December, the OST program is currently running for intravenous drug users (IDUs) in the capital Nairobi, and there are plans to eventually expand to Mombasa and Malindi.
Kenya has approximately 18,327 IDUs of whom around 18 percent have HIV, according to the 2014 Kenyan AIDS Response Progress Report. This is a staggering 3-4 times the prevalence of the general population which stands at 5.6 percent.
As the report notes, safe injecting practice among IDUs is generally low (51.6 percent) and exacerbated by the low provision of sterile injecting equipment which only reached around 15 percent of the affected population in the 12 months prior to the report's publication. Such figures highlight the importance of scaling up harm reduction in the country.
While the Nairobi OST program is relatively small scale and in its infancy, it is a vital addition to combating the problem and should hopefully pave the way for similar initiatives to be rolled out in the future.
Throughout Sub-Saharan Africa, harm reduction programs are extremely scarce, though there are a few similar examples to the newly-opened Nairobi initiative.
Mauritius introduced an OST program in 2006, one that currently serves over 6,000 people in the country. At the beginning of this year, it was announced that these services will be further decentralized, a move that the Minister of Health and Quality of Life stated will increase the number of sites allowed to dispense methadone, ultimately improving access for patients.
Kenya's neighbor Tanzania, meanwhile, now has the largest government-run OST program in the region, with an increase from the one site that opened in 2011 in Dar es Salaam, to three. It has generated some promising results; in 2013, over 1,200 individuals received methadone maintenance as well as 20,000 people being offered access to treatment through its outreach program. A shortcoming of the Tanzanian model, though, is that takeaway doses remain unavailable.
The Seychelles also has a center offering OST.
Though there are two more initiatives in the region, access is severely limited. As noted in The Global State of Harm Reduction 2014 report, there is only one OST facility available in South Africa that is government funded, with the vast majority of provision offered privately instead. There are plans to increase government-funded services, though until there is a significant shift from private to public, countless IDUs in South Africa will not have access to OST.
Additionally, Burkina Faso only offers private OST.
The steps being made to increase the prevalence of OST sites across sub-Sahara Africa are commendable, although undeniably slow. The high demand for drug dependence treatment in Kenya and other countries in the region needs to be met by funding and a deep commitment from governments to combat these health concerns
Sub-Saharan Africa is the most severely affected HIV area in the world accounting for 71 percent of the global population of HIV sufferers, according to the World Health Organization (WHO). Unless the issue is tackled on all fronts, and all impacted communities are helped, this fact will not change anytime soon.